Keratoconus: an analysis of corneal asymmetry

Background: Keratoconus, a non-inflammatory corneal ectasia, is reported to have bilateral involvement in over 90% of patients. The purpose of this study was to quantify the extent of asymmetry of disease at presentation to a regional corneal clinic.

Is hyperfiltration associated with the future risk of developing diabetic nephropathy? A meta-analysis.

Aims/hypothesis Glomerular hyperfiltration is a well established phenomenon occurring early in some patients with type 1 diabetes. However, there is no consistent answer regarding whether hyperfiltration predicts later development of nephropathy. We performed a systematic review and meta-analysis of observational studies that compared the risk of developing diabetic nephropathy in patients with and without glomerular hyperfiltration and also explored the impact of baseline GFR.

Methods A systematic review and meta-analysis was carried out. Cohort studies in type 1 diabetic participants were included if they contained data on the development of incipient or overt nephropathy with baseline measurement
of GFR and presence or absence of hyperfiltration.

Results We included ten cohort studies following 780 patients. After a study median follow-up of 11.2 years, 130 patients had developed nephropathy. Using a random effects model, the pooled odds of progression to a minimum
of microalbuminuria in patients with hyperfiltration was 2.71 (95% CI 1.20–6.11) times that of patients with normofiltration. There was moderate heterogeneity (heterogeneity test p=0.05, measure of degree of inconsistency=48%) and some evidence of funnel plot asymmetry, possibly due to publication bias. The pooled weighted mean difference in baseline GFR was 13.8 ml min-1 1.73 m-2 (95% CI 5.0–22.7) greater in the group progressing to nephropathy than in those not progressing (heterogeneity test p<0.01).

Conclusions/interpretation In published studies, individuals with glomerular hyperfiltration were at increased risk of progression to diabetic nephropathy using study level data. Further larger studies are required to explore this relationship and the role of potential confounding variables.

Homocysteine, Methylenetetrahydrofolate Reductase C677T Polymorphism, and Risk of Retnal Vein Occlusion: A Meta-analysis

Objective: To assess the role of plasma total homocysteine (tHcy) concentrations and homozygosity for the thermolabile variant of the methylenetetrahydrofolate reductase (MTHFR) C677T gene as risk factors for retinal vascular occlusive disease.

Design: Retinal vein occlusion (RVO) is an important cause of vision loss. Early meta-analyses showed that tHcy was associated with an increased risk of RVO, but a significant number of new studies have been published. Participants and/or Controls: RVO patients and controls.

Methods: Data sources included MEDLINE, Web of Science, and PubMed searches and searching reference lists of relevant articles and reviews. Reviewers searched the databases, selected the studies, and then extracted data. Results were pooled quantitatively using meta-analytic methods.

Main Outcome Measures: tHcy concentrations and MTHFR genotype.

Results: There were 25 case-control studies for tHcy (1533 cases and 1708 controls) and 18 case-control studies for MTHFR (1082 cases and 4706 controls). The mean tHcy was on average 2.8 mol/L (95% confidence
interval [CI], 1.8 –3.7) greater in the RVO cases compared with controls, but there was evidence of between-study heterogeneity (P0.001, I2 93%). There was funnel plot asymmetry suggesting publication bias. There was no evidence of association between homozygosity for the MTHFR C677T genotype and RVO (odds ratio [OR] 1.20; 95% CI, 0.84–1.71), but again marked heterogeneity (P 0.004, I2 53%) was observed.

Conclusions: There was some evidence that elevated tHcy was associated with RVO, but not homozygosity for the MTHFR C677T genotype. Both analyses should be interpreted cautiously because of marked heterogeneity between the study estimates and possible effect of publication bias on the tHcy findings.

Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

The Doppler shadow of WASP-3b. A tomographic analysis of Rossiter-McLaughlin observations

Context. Hot-Jupiter planets must form at large separations from their host stars where the temperatures are cool enough for their cores to condense. They then migrate inwards to their current observed orbital separations. Different theories of how this migration occurs lead to varying distributions of orbital eccentricity and the alignment between the rotation axis of the star and the orbital axis of the planet. Aims: The spin-orbit alignment of a transiting system is revealed via the Rossiter-McLaughlin effect, which is the anomaly present in the radial velocity measurements of the rotating star during transit due to the planet blocking some of the starlight. In this paper we aim to measure the spin-orbit alignment of the WASP-3 system via a new way of analysing the Rossiter-McLaughlin observations. Methods: We apply a new tomographic method for analysing the time variable asymmetry of stellar line profiles caused by the Rossiter-McLaughlin effect. This new method eliminates the systematic error inherent in previous methods used to analyse the effect. Results: We find a value for the projected stellar spin rate of v sin i = 13.9 ± 0.03 km s-1 which is in agreement with previous measurements but has a much higher precision. The system is found to be well aligned, with ? = 5-5+6° which favours an evolutionary history for WASP-3b involving migration through tidal interactions with a protoplanetary disc. From comparison with isochrones we put an upper limit on the age of the star of 2 Gyr.

Possible evidence of asymmetry in SN 2007rt, a type IIn supernova

An optical photometric and spectroscopic analysis of the slowly-evolving type IIn SN 2007rt is presented, covering a duration of 481 days after discovery. Its earliest spectrum, taken approximately 100 days after the explosion epoch, indicates the presence of a dense circumstellar medium, with which the supernova ejecta is interacting. This is supported by the slowly-evolving light curve. A notable feature in the spectrum of SN 2007rt is the presence of a broad He i 5875 line, not usually detected in type IIn supernovae. This may imply that the progenitor star has a high He/H ratio, having shed a significant portion of its hydrogen shell via mass-loss. An intermediate resolution spectrum reveals a narrow Ha P-Cygni profile, the absorption component of which has a width of 128 km s-1. This slow velocity suggests that the progenitor of SN 2007rt recently underwent mass-loss with wind speeds comparable to the lower limits of those detected in luminous blue variables. Asymmetries in the line profiles of H and He at early phases bears some resemblance to double-peaked features observed in a number of Ib/c spectra. These asymmetries may be indicative of an asymmetric or bipolar outflow or alternatively dust formation in the fast expanding ejecta. In addition, the late time spectrum, at over 240 days post-explosion, shows clear evidence for the presence of newly formed dust.